| Objective Immunotherapy is a new and most promising therapeutic method after traditional therapy.As one of the most promising immunotherapy strategies,Programmed cell Death 1(PD-1)/Programmed cell Death Ligand 1(PD-L1)inhibitors have made breakthroughs in the treatment of some refractory tumors.However,the effective rate of PD-1/PD-L1 inhibitor in overall patients is not ideal,which greatly limits its clinical application.Therefore,accurate selection of predictive biomarkers is crucial for individualized immunotherapy of tumor patients in clinical practice.Biomarkers that reflect the immune microenvironment and intrinsic characteristics of tumor cells,such as PD-L1 expression and tumor mutation board(TMB),have been noticed to be related to the therapeutic effect of anti-PD1/anti-PD-L1.In this study,the significance of the correlation between TMB and PD-L1 expression in the esophageal squamous cell carcinoma(ESCC)and the clinicopathological significance of the two expressions were analyzed,so can further explore the important of biomarkers in prediction of the outcomes of immunotherapy.Methods 1.100 tumor tissue samples were collected from patients who underwent radical resection of esophageal cancer in Taizhou People’s Hospital,Jiangsu Province,from June 2018 to June 2020.The patients were aged 49 to 79,with a median age of 67.All patients were pathologically diagnosed as esophageal squamous cell carcinoma.All patients did not receive radiotherapy,chemotherapy and immunotherapy before surgery,and obtained written informed consent of the patients before surgery.The project was approved by the hospital ethics committee.The 100 patients were divided into TMB-H and TMB-L groups by second-generation gene sequencing.The expression of PD-L1 in each tissue sample was detected by immunohistochemical method,and the correlation between the expression of PD-L1 and TMB was analyzed.2.To analysis whether the expression of PD-L1+and TMB-H in ESCC tissues was statistically significant with gender,age,smoking,lymph node metastasis,tumor site,EGFR overexpression and TNM stage.Results 1.PD-L1 was not only expressed in the cell membrane and cytoplasm of tumor cells,but also expressed in the infiltrated tissues around the tumor,and the expression rate in tumor tissues was higher than that in adjacent tissues 54%(54/100)vs22%(22/100),(?)~2=21.732,P<0.001,showing statistical difference.2.The expression of PD-L1 in esophageal squamous cell carcinoma has no significant correlation with gender,age,smoking,diseased region,differentiation degree,EGFR mutation,infiltration depth,and lymph node metastasis,but has correlation with TNM stage.((?)~2=5.487,P=0.019,the difference was statistically significant)3.The expression rate of TMB-H in esophageal squamous cell carcinoma was 57%(57/100),and it was not significantly correlated with gender,age,smoking,lesion site,degree of differentiation,EGFR overexpression,depth of invasion,and TNM stage,lymph node metastasis.4.There was no significant correlation between the expression of PD-L1 and TMB in esophageal squamous cell carcinoma.((?)~2=0.244,P=0.621)The combination of PD-L1+and TMB-H had no significant correlation with any clinicopathological factors.Conclusion This study found that patients with ESCC,TMB and PD-L1 as an early screening of clinical and biological markers and molecular targets immune treatment,there is no clear correlation between them,prompt PD-L1 and TMB immunotherapy may be as a biomarker of two independent factors,single marker detection can not effectively forecast the curative effect of immunotherapy,benefits the research for more accurate prediction of immunotherapy crowd has a certain significance,lay the foundation for further implementation of accurate immunotherapy. |
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